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Repair of a Small Palate Laceration

Maine rates for HCPCS 42180

This surgery repairs a cut or tear in the palate, the roof of the mouth, that is small in size. The surgeon cleans the wound and closes it with stitches to restore a normal, intact palate. It is typically used after an accidental injury, such as a fall with an object in the mouth, rather than for a birth-related palate condition.

Rates data updated July 2026.

How much does Repair of a Small Palate Laceration cost?

$302

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $302 for this service. Most negotiated rates run $224 to $417.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $457 · 10th to 90th $457 to $457Professionalmedian $302 · 10th to 90th $204 to $589
$200$500$1Kfacility $457professional $302

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$309.03
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$316.23
Typical High
$588.84
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$371.54
Typical High
$676.08
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$251.19
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$316.23
Typical High
$575.44

Where Maine sits

The same service costs 2.2 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 13th of 51

$302

MN $501WV $224

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.